Coping skills

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It’s Time To Grow Up

 

 

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Fragile Annie writes a blog called, “It’s Time To Get Over How Fragile You Are.”  Isn’t that a great name?  She own’s her frailty, own’s that it has affected her life, and own’s what it’s time to do now.  All in a name and a title.

When I was in psychotherapy, talking on about injustices suffered, my feelings, the rightness of my condition – my therapist said, “It’s time to grow up Sana.”  I still feel the punch in my stomach and the quiet immediately following.  I couldn’t breath for a bit.  Just nodded my head.  “Ok.”  …I said, “Ok” a few times.  I don’t remember much else of what he told me but I don’t think I’ll ever forget that.  He’d be satisfied with his work with me if he knew.

After all, it’s not such a small thing to grow up, or “get over” our frailty.  It’s not such a small thing to see our need.  It’s not so little to act on it.  These are things that champions do.  These are things any coach, parent, therapist, teacher would be proud to be a part of.  These are the things that make the difference between falling victim to your history, or claiming the rights to your now and to your future.

Think about what is upsetting you the most.  What seems to keep at you and trip you and keep you back and keep you right where it left you last?  It’s time to grow up.

Self-Care Tip #106 – In Fragile Annie’s own words, “It’s time to get over how fragile you are.”  Be a friend to yourself.

Question:  What has knocked your breath out in a good way, sending you off towards growth?  Please tell me your story.

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Growing Up Is Not Necessarily The Same as Growing Away

 

cant decide so dance

Image by faster panda kill kill via Flickr

 

Self-Care Tip #105 – Grow up, think on your own, and stay connected.  Be a friend to yourself.

Staying connected doesn’t mean loosing your freedom.  Staying connected doesn’t mean immaturity.  And independent thought doesn’t mean disconnecting from others or your foundation in life.

When we move into adulthood, we move into roles requiring responsibility, autonomous decision-making, teaching like parents.   This is confusing don’t you think when we were designed to be connected?  Well when something feels so wrong inside, listen to it.  There is a incongruence with what you intuitive know.  Independence includes dependence

Adulthood means learning to have creative thought while being willing to learn.  It means disconnecting while remaining connected.  It’s not all-or-none.  It’s seeing the strength in vulnerability.  Part of taking care of “Me” includes choosing dependence.

Dependence never takes away freedom.  Sometimes when I listen to people telling me how I should feel or think, I feel caged and start doing things to make me feel less caged.  Unfortunately sometimes that isn’t a healthy thing, like eating chocolate or… well it’s often eating for some reason.  Other people do this too.  They may cut on themselves or bang their head.  Unnecessary, because we are free no matter.  Drugs.  Whatever it is that in the moment somehow springs you from the phantom cage only to put you in another.

Question:  How do you live free yet connected?  How do you deal with feelings of infancy, immaturity, loosing freedom when it comes?  Please tell me Your story.

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Your Life. Your Choice. Why Are You Still Negotiating?

 

 

Self-Care Tip #102 – Take what is yours and live.  Be a friend to yourself.

Cheri came, still dressed in work scrubs, with her 2 daughters, 8 years old and 3 years old.  Having finished their dinner date, they were swinging by for her appointment before going home.  Cheri told her kids, “Get out now and go sit in the lobby!  If you don’t listen to me I’ll….”  Turning to me, she said, “It’s never enough!  I just took them to dinner and they do this to me!  No matter what I do…!”

1.  Cheri tells me she’d like to cope better with simple stressors such as redirecting her kids

2.  We talk at length about her perception of her kids abusing her.

Cheri is married.  Her husband laughs at her for “…having to take those drugs to be normal!”  “…But he just sleeps his problems away.  He doesn’t deal with them like I do.  He has no idea!”

3.  We talk more about her perception that her husband is responsible for her place in life.

Cheri believes if she doesn’t take more than 2 pills a day, she is less “dependent” on drugs.  She says, “I don’t want to go on like this!”  Her tears continue talking when her voice stops.  She is ashamed.

4.  The concepts supporting taking care of yourself as being the kick-off point to caring for anyone else comes up.

5.  We talk some more about who is “The Why” for what we do or don’t do.

Cheri feels less shame, but it’s still there.  She is willing to give a new medication a try but clearly doesn’t buy it all yet.  She’s going home with her girls to her husband with new pills.  And hope?  Yes.  It is all connected.  It all pulses together and is a living negotiation of sorts.

Disease <–> behavioral/emotional negative symptoms <–> victim role <–> self-neglect <–> greater crisis <–> seeking help <–> responsible self-care <–>  healing <–> fewer behavioral/emotional negative symptoms <–> emotional abuse from husband may continue but is no longer seen as responsible for personal choices and self-care <–> less shame <–> further healing and so on….  (Lub-dub…Lub-dub…)

 

hbofamily.com

 

Cheri is still negotiating her deal in life.  She doesn’t realize that it’s already hers for the taking.  Her life.  Her choice.

The deal is already made.  Take it or leave it.  Your life to live.

Question:  How are your negotiations?  Do you see them as still in progress or settled.  Please tell me your story.

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It’s Not All Good

 

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Self-Care Tip # 100 – Don’t forget what you know to be true, when other people don’t keep up with your learning curve.

You have finally started to understand that You take care of you.  You bought into that when you do, you can do more of what you want to do for others.  You believe that the responsibility to be healthy in mind and body starts and ends with the “Me.”  Isn’t that wonderful?  Yes.  Don’t forget it when other people don’t keep up.

Cynthia was on a self-awareness high.  She saw through open eyes her neglected self.  She was astounded looking at her thrashing person giving her last bit of stuff to the jobs she infrequently satisfied.  Instead of feeling defeated, however, she now felt empowered.  She was so ready!

It went well for a time.  Her husband noticed, approved, commended, and encouraged her.  They talked about it.  Her kids, reluctantly let go of her legs so she could leave to exercise.  At work, she personalized less and was not as interested in office politics – contented to do her own job.  Then it slowly started.  People started resenting her for it.  Her peers starting making jabs.  The kids would climax and tantrum just as she was about to leave to exercise.  But what really surprised her, and not in a good way, was when her husband got upset.  Not a lot.  But enough that the guilt she had talked down seized the opportunity to multiply.  It was like gremlins.  When the guilt gets wetted like that, it multiplies!

Doing what is right is not always celebrated.  Cynthia is working through that now and every day, as it is for you and me, she is finding the courage to get past that.

Question:  What has surprised you good or bad in your journey towards self-care?  What have you needed the most courage for?  Please tell me your story.

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Getting Away From All-Or-None Thinking

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Image by DanaMums via Flickr

Self-Care Tip #98 – Getting out of all-or-none thinking may mean getting medical help.

Number five on Bella’s list:

“The day has been ruined!” Bella said.  Her eyes sparkled and flashed as she spoke of her injury.  Bella was not so pleased with her labor’s reward.  She was not so satisfied with being accountable for her children‘s behaviors, when they thwarted her every effort at having a good family experience.

A reader eloquently commented what I now want to write on my mirror, about her walk through and away from all-or-none thinking:

..really only part of my day was ruined – the part when I was hurt or angry or frustrated or depressed, etc. – and, even then, only PART of me was totally miserable. I was still able to think about other things, get things done around the house, talk to a family member or friend. It’s really calming to know that I can hurt and still function because there are so many pieces of me and my life that are still okay. Suddenly, everything seems to be easier to deal with.

In an earlier post, “Adequate,” we talked about the truth being in the gray.  As my Dad so often told me,

Things are never as bad as they seem.

I had a hard time believing that at times when I was a kid, and now that I’m old-er 😉 I buy it cognitively but find I often doubt is at an emotionally intuitive level.  However, things do get much much much better for all of us after good sleep, exercise, water, and if medically needed, medication.

All-or-none thinking, extreme thinking, catastrophizing isn’t just about coping skills.  It can also be about our medical condition.  It’s very difficult to modulate emotions when you are emotionally ill.  I’ve heard so many confounded people say that they just couldn’t stop themselves from going into extreme emotions.  They struggled with reactions way past what the experience warranted.

A kid doesn’t listen to words and Dad is kicking a hole in the door.

A couple argues over levels of intimacy and the girl finds herself in the bathroom with a cutting tool.

Work is another day of punitive treatment by an employer with lesser intelligence and she’s vomiting up food.

In these examples, we reflexively coddle the person, saying, “Anyone would be upset if….”  However that is not true entirely.  Enabling someone’s illness is easy to do.  Bad things happen to everyone.  But not everyone responds in a way that is repeatedly unhealthy to themselves.

In order to treat ourselves well, we need to take care of our physical/biological/medical needs.  Say hypothetically that we are getting our sleep, and all that good stuff, yet still have involuntary inappropriate extreme emotions, think about an organic reason.  Give yourself a break.

I have told my Dad, “True, things are never as bad as they seem, but only as long as you get out of their current seeming-reality.”  Getting out of that reality, may mean getting medical help.

Be a friend to yourself.

Question:  How do you stay “adequate?”  Please tell me your story.

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Choose Well, What You Will Live For

Self-Care Tip #96 – Choose well, what you will live for.

Yesterday we discussed finding our reference point for why we do what we do.  All day today I found my thoughts returning there and had to spend another blog-post-opportunity on it’s “friendliness.”  I was happy to find that I was not the only one when I got a reader‘s response:

I’m still coming out of the fog of doing anything for survival-as-a-habit.  As in, being in panicked survival mode even when all is calm and safe–that is no way to live, any dog knows better than to live like that.

I contrast her response with my colleague’s:

The intentions of any life is self-serving.  Altruism doesn’t exist except in God, (which I accede not to understand), and people can’t rise above their own genetics.

Now this man is the kindest, sweetest, most generous man you’d ever meet and he doesn’t say these things with any meanness, anger towards a past offense, or to turn people from God.

However, contrast his take on our reference point in life with the reader’s above.  She talks about her choice.  Can a choice transcend our genetics?

You may remember some of a previous post mentioning the work of MIT neuroscientist, Sebastian Seung. His research tells us that memories are stored in our neurons and not in our genes.  Eg. Habits are memories and not genetic therefore not permanent.

There is an interplay between choice and genetics.  YES!!@!!  We aren’t robots!  😉  Nor are we a picture without a frame.  We so often don’t think about all the good that our genetics do for our lives.  There’s just so much talk about how we fight our genetics.  We have been given both a design and free choice.  Of course we can’t change our design, but as our reader later said so well:

For some people it is a process just to ask “why am I doing this?” … AND actually ask that question to themselves. (man-o-man the times I have asked everyone else why I was doing something) Maybe it will take sometime for an answer to come, but asking means we are on our way!

Choice is the gift from God that the apple and the serpent and thousands, or billions of years (what ever is true) can’t take away from us.  Only you can.

Be a friend to yourself.

Question:  Where are you in process between your choice and your design?  Is the interplay one that is smooth or rocky for you?  Please tell me your story

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What We Get For Our Work

 

 

Number three on Bella’s List:

Farmer Brown hired help to get his crop in.  Half way through the job, he realized he needed more help, so he got some.  This happened at least 3 times before the job was finished.  Come paying time, Farmer Brown gave everyone the same, $100.  “What’s going on here!?” the people who worked the longest complained.  “We should get paid more!”

Farmer Brown, …well you probably know that this is my version of the story from Matthew 20:1-16.  The Farmer gave them more than money.  But what did he give?

What are we getting for what we do?  Intuitively we probably think, like the hired farm-hands, and like my patient Bella, that we aren’t getting what we should at times.

“The day has been ruined!” Bella said.  Her eyes sparkled and flashed as she spoke of her injury.  Bella was not so pleased with her labor’s reward.

The real point of our stories here – the hired farm-hands, Bella’s, and our own story – is figuring out the reference point of why we do things.  Everyone makes their reference point in their own way.  Find your reference point.  Just find it.  You’ll get more for your dollar, so to speak.

You might remember from some earlier posts, about doing what is congruent with our hard-wiring, i.e. our temperament.  This gives us more joy in our work, we are better at what we do, we feel less self-pity, and an energy generated simply by our own natural interest drives our efforts.  As a believer in biology, I’d list temperament not as a reference point, but as an influence of how we search for and how we define our reference point.

Finding our reference point is not impossible if we don’t do what comes natural to us.  Finding our reference point is impossible though if we aren’t looking.

After searching in my special way for why I do what I do in life, I found God.  Is that true?  Just ‘cuz I said God is my reference point, doesn’t make it true.

Self-Care Tip #95 – Find your reference point.  Be a friend to yourself.

Question:  Have you actively, purposefully used your biology (like a hoe in the field) to find why you do what you do?  Is it helpful?  What have you found?  Please tell me your story.

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Are You a Victim or What?!

 

 

Number Two of Bella’s List – victim or what!?:

Last night I took my 5 year-old daughter on a sleep-over date at a hotel.  Generous I thought …and boy was it!  To me!!  I couldn’t believe how much fun I had.  I quickly realized why I had done this.

A bit of me still wants to float away on wings of the modern-martyred-Mom, and I can, because it did take a lot of time and money and energy and….  But it’s not too friendly to me.  As attractive as that flight may seem, I’ll lose air at some point and take a big fall.  Ouch.  I might fall on my kid too which is against my intuitive effort here.

Being a victim is attractive at some level, no?  My story is a softer example, but we all have tougher ones.  Like Bella’s when “she spoke of her injury.”  The gravity of her injury was created by her perception of things.  Our perception makes our emotional success.  My story about last night with my daughter sounds pretty because that’s how I perceived it.  However, I have other stories that have negative power over me as Bella’s had on her and as yours have on you.

The key here is that when we take the victim role, we aren’t just telling our story or venting.  We are feeling self-pity. But venting is not necessarily self-victimization.  Venting can be healthy.  Venting can be done without taking a victim air-bus to no-where good.  Venting can be a way of being present in your suffering, of going where the pain is and letting it lose power over you.  Self-pity only gives the suffering more power.

The great novelist and philosopher, David Foster Wallace, who courageously lived and died with major depressive disorder, encouraged,

To be just a little less arrogant. To have just a little critical awareness about myself and my certainties.

The willingness to learn or grow is the foot-path away from victim-ville.  Could we even say that being a victim is “arrogant?”  We – Me, my patient Bella, you – have we taken steps to tell our story, to be present, to live with the humility it takes to look at ourselves and not escape/fly-away?

Whatever it is you are going through, it might help to vent it!  Grow and learn and get bigger than that experience.

Self-Care Tip #94 – Get in your own space to choose freedom from self-pity.  Be a friend to Yourself.

Question:  What barriers have you felt to telling your story?  What has made it difficult to be in the space of your own feelings?  Please tell us.

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Walk Away From Your Junk

the rogers park young women's action team

Image by samuelalove via Flickr

Number one on Bella’s List:

There are endless new beginnings.  Had a bad day?  Stop right where you are and call-it out.  Then if you want to, if you are willing, if you are able you can start again.

But who is able?  Anyone who wants.  Even the severely disabled can say at some level that they want to end the hurt.  New beginnings are a privilege.  They are the dandelions we pluck and make a wish on.  It reminds me of when Jesus,

walked right through the crowd and went on his way.

The people were trying to push him over the cliff and they just plane didn’t see him walk among them and away.  We do that sometimes with our “start-over” opportunities.

There’s an interplay of forces that make our new beginning possible or impossible.

  • Humility – a willingness to learn.
  • Biology – a physical ability to stop, drop and roll the fire that’s scorching our emotions
  • Insight
  • Choice – choose it

Bella told me more of her story.  After she said, “The day has been ruined!,” her husband took them all to the table.  He told the kids, “Mom’s right.  The day is ruined.  Now who wants to start over?”  And then they all prayed for a new start.  They walked away from the junk.

Self-Care Tip #93 – Start over any time, every time you want.  Be a friend to yourself.

Question:  Do you find this to be true for you?  Is it a real option to start-over when you want?  Please tell me your story.

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    Recipe for Treating Panic Disorder, According to Me

     

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    Recipe for Treating Panic Disorder, According to Me:

    1.  If it’s taking you to the emergency room feeling like you’re going to die, or your spouse can’t peel you off with your phone calls and new needs – you have a medical illness.  Get medication.

    2.  If you are afraid of being humiliated by an episode so much that you avoid public places, or if you are more fearful than not – you have a medical illness.  Get medical treatment.

    3.  If you are panicking out of the blue, without something setting you off/triggers like finding your husband in bed with your dentist – this is biological.  Get a medical physician’s opinion.

    4.  If you are awakening from sleep in a panic attack, when you feel like you have to get out of bed and escape and the episode lasts for about 10+ minutes before you recover yourself – this is not because you’re not trying hard enough.  Get on a serotonerigic therapy and a sleep aid(s).

    5.  If you are drinking more alcohol to relax and out of fear of going to bed – get suspicious and get smart.  Medication therapy or alcohol?  It stumps me when someone says they don’t feel comfortable with taking medication that has beed studied in double-blind studies on thousands of people and reviewed and analyzed and more… but they do feel comfortable with alcohol.  That’s not friendly with yourself.

    6.  If you think you are going crazy and realize your fears and suspicions don’t make sense; if you think you are possibly going psychotic over and over – you’re having a medical illness of the brain and body called panic disorder.  Get to your nearest treating physician and trust them.

     

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    7.  If this is you, don’t go get insight or supportive psychotherapy at least until you have been on medication therapy for 6-8 weeks.  What you are going through is not because your mom yells at you too much.  It doesn’t have to have a reason.  It is medical.  Treat it medically.  If you go to therapy too soon, you will see that you can’t give what you don’t have.  (I may have offended some people saying this.  Sorry.)

    8.  If you don’t get treatment, expect that depression may likely follow soon.  Anxiety and depression are bedfellows and can’t be apart for long.

      Self-Care Tip #92 – View Panic as a medical illness.  It is.  Be a friend to yourself.

      Question:  Have you or someone you known used a similar recipe or a different one?  Please tell me your story.

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      Escape Self-Loathing

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      Self-Care Tip #91 – Put the fight down and take 2 steps back.  Be a friend to yourself.

      He came in looking really good.  Chris had seen me for many years and he hasn’t always looked this way.  I said

      You look great!

      Chris shrugged and told me he had just had a long messy argument with his partner and somehow still felt alright.  In the past, after they fought and the self-loathing set in, he might have hurt himself – like using alcohol or cutting on himself to

      …just feel something different.

      I was ready to move past the story as he sounded like he was ok with it.  We talked past each other.  Me asking about his sleep, and Chris telling me clips and phrases from the argument.

      But amazingly I’m fine!  If he wanted me out today, I’d be out of there, no problem.  He just needs to say the word!

      Chris was sitting back in his chair, relaxed until then.  His hands came up and took control of his space, thrusting as he spoke.

      Being a psychiatrist, my expertise kicked in and I realized I should turn back.  Chris wasn’t ready to talk about sleep.  You see what all those years of school can do.  Not everyone knows how to pick up on such subtleties.

      Chris, maybe you aren’t so happy you argued.

      We talked more about his energy, appetite and motivation.  Then we came back to his argument.

      It’s none of his f—— business where I am during the day!  I’m not his child.  I’m his partner!  I told him…!

      And so on.  Chris still looked better than when he was in the grip of post-traumatic stress disorder symptoms, or when he was catatonic.  But he didn’t sit comfortably with himself.  And I thought, Chris has fought so hard for himself, why can’t he handle what I want to say?  And I did.  And he did.  Beautifully.  He was a brave knight on a black steed holding his wounded sides.  Life had been a battle for him, but he was making choices to fight less and live more.

      “Ok.  Yes.  You’re right.  I will next time.  That makes sense.”

      When you’re about to engage in something that in the end will make you loath yourself, choose not to.  That’s friendly to you and your other.  Say something like,

      When I was gone you felt jealous?

      Give over stage and anger and open windows and breath.  Just choose not to hurt yourself.  Winning or losing the argument, in the end, you hurt by your own choice.

      Biologically and probably spiritually Chris wouldn’t have known what to do with that years ago.  But he did now.  I saw him relax again and put his hands away.  I knew Chris had a love for Love and this clicked for him.

      I can’t describe how happy I was/am.  Being a part of his journey is a great honor.

      Question:  How have you escaped self-loathing and your mean self in the heat of the moment?  Please tell me your story.

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      You’ll Be Less Bored if You Do

       

      Rocky Balboa

      Image via Wikipedia

       

      Self-Care Tip #89 – Practice being real.  Exercise it!  Be a friend to yourself.

      Sara Stein MD and author of Obese From the Heart, wrote

      There’s nothing romantic or mysterious about advanced age. It’s painful and difficult for everyone, but there are good moments.

      I like that.  We could say it about a lot of other things too.  Just today in clinic for starters, Mary said she’s falling asleep during the day, but is doing less self-injury since starting topiramate.  Max has gained about 20 pounds but he is over his Staphylococcus infection and he’s sleep through the night.  Marge is crying because there is no cure for her son’s illness, but he can still be treated medically and protected against further disease progression.

      Any time someone asks me how I’m doing, I’m in a paradox.  It’s the drive I struggle with to express emotions purely and completely that can be my own Rocky (Dir: John G.Avildsen, 1977) experience or it can kick me in the back-side.  Doing what Dr. Stein so eloquently did isn’t as easy as it looks.

      “Fine,” I say.  “Things are wonderful.  Thanks for asking.”  (Snore.)

      Or, (trip,) “I’m tired and parenting is difficult, and as much as I talk about it, I can’t seem to figure out how to take care of myself.  But I’m also really good and haven’t been this happy in a long time.” (Panting holding my sides.)

      Being real without boring or tiring yourself out might take some practice.

      The “real-thing,” blogger Film Fan wrote

      Philadelphia Museum of Art, Benjamin Franklin Parkway, 26th Street, Philadelphia, Pennsylvania, USA.  The most famous location in Rocky is probably the stairs he jogs up during the ’Gonna Fly Now’ training montage. The good news is that you can re-enact the scene and jog up and down them, the bad news is that there are 68 steps… That’s quite a few if you’re jogging.

      If you ever want to get bored quick, try to be happy.  Try it.  Try to be good.  Try to ignore the monotony.  If you want to be bored, draw your house with a window and a door and a sun shining in the corner.  It’s no good for boredom when you draw in the shadows and colors.  But doing that well might not be natural for everyone.  We might need to get into a training program, like Rocky Balboa before we can be in the presence of the bad and the good of our lives without loosing our breath.

      It may take practice to be real, but you will be less bored if you do.

      Question:  How do you find being real with the good and bad of your life affects you?  Please tell me your story.

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      Lure Yourself Like a Lover

       

      Art Gallery Bangkok

      Art Joy by Marie Schem

       

      Self-Care Tip #88 – Win yourself over.  Be a friend to yourself.

      Dr. White works with mostly women in primary care medicine.  She tells me that her women so often come in tired, overextended, and they say they don’t feel good.  She wonders why they think they can run 2 full-time jobs (parenting and employment) without suffering for it.  Her counsel is to down scale.

      My patients do so much better when they are working part-time.

      Christie, a mom of 3 who works full-time, tells me tonight,

      It’s hard.

      That’s not new news but nor is it small news.  How many of us nod when on the subject of self-care.  We sagely stroke our chin yet are nowhere to be found on the list of topics of interest.  Do we even get pleasure out of taking care of ourselves?

      I think there’s a misperception here.  The hard part is not doing the 2 jobs that Dr. White’s patients work.  It is working our own person.  Maybe if we found more pleasure in caring for ourselves we would.  Maybe if we connected that caring for ourselves is the minus-1 to the starting point of caring for others.  We can get hooked.  We can.  But it won’t be the same for all of us.   Any way you turn it though, we have to make it sticky, linked to pleasure, and making sense.

      Question: Is there anything specific you can think of that contributes to self-care being a positive thing in your life?  Please tell me your story.

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      Why Are You Walking The Road Alone?

      Part of humility is not isolating.  You have to be able to receive to be a friend.  Dan Allender Ph.D. calls it suffer the kindness.

      From looking at him, I didn’t guess at first that Fink was lonely, but he was.  Under-appreciated, whenever Fink thought about making new friends, he remembered that he wasn’t young any more.  All his “real” friendships were made when he hung-out for hours, had spares in the trunk so to speak.  If one relationship didn’t develop well, he still had time and possibilities that the future offers.  In this sense, Fink had been rich.  He had after all that, maybe 3 friends he considered “real.”  But over the last several years, with real jobs and families of their own, his real friends weren’t returning his calls.  Now, he thought, he may as well as not have given them his special self.  Now he was older and not so rich.  Fink kept picking at that scab, even though he knew it wasn’t so masculine to be upset about your neglected special self.

      At times we are lonely, but have trouble valuing the relationships being offered.  We see ourselves as something set apart.  This might be part of our drive to self-preserve.  Bits of neurons fighting over signals in our brain telling us that we need to dominate to propagate our genes.  Maybe.  But there is that intersection when choice crosses.

      We remember from Sebastian Seung‘s work that our memories are not stored in our genes.  That gives us something tangible to work with.

      I remember walking on the beach with a girlfriend when we were still in medical school.  I told her, “I’m tired of feeling bad about things I never had a choice in!”  It still seems wasteful to moralize things like temperament and our nature.  In fact, we’ve argued the opposite at length in previous blog posts.  Embrace that part of you and run with it! we said.

      So what do we do with Fink?  For starters, tell him that his drives are what they are.  The real question is, what’s he going to do with his genetic drives?  Do good things with that energy?  (If we can call genetic drive an energy.)  Or will he do things that aren’t so good for him.  There comes the choice.  Fink.  Suffer the kindness.  (Thanks Dan Allender!)  In the end you will be happier and healthier for it.  Even if you are half as hot as your genes tell you you are, who cares if you are walking the road alone.

      Self-Care Tip #86 – Suffer the kindess.  Be a friend to yourself.

      Question:  What has been a barrier in your life from connecting with others?  Please tell me your story.

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      by

      Get Gangster on Your Shame

       

      Photo by Wesker

       

      Shame.  Ah what a cloaked villain!  In this post I’m going to tell you about why shame is not an enemy you want to ignore.

      “Michael Corleone” in The Godfather Part II was not the 1st to say it, but maybe was the first to make the quote famous

      Keep your friends close and your enemies closer.

      Not many people would at first think that keeping shame close might be a good thing, but I’m here to tell you that it is.

      Meet Bill the highway patrol.  He’s been seeing me for melancholic depression.  Sometimes he feels a little better, but those times even still are not so great.  Bill has told me about where he thought his anxiety and fear came from.  His story made sense to him.  This wouldn’t be too much of a problem except that he thought about it often.  Very often.  He was running in sprints away from it.  Somehow after all the time he’d spent reluctantly in the presence of his fears, he hadn’t realized that shame was connected.  Shame of being treated the way he had been.  Shame of being misused.  He hadn’t faced his fears because he was always angled away from his thoughts of shame.

      If we don’t go where the shame is, we won’t be free from its effect on us.  Fear is a big bad bully.  Until you turn around and say stop, you’ll be running for a long time.

       

       

      We all need to be a bit “gangsta” at times.  Ignoring shame is not.  It’s not emotion-street smart.  I’m waiting for Bill to think, “What’s the worst thing that could happen?”  And sit in the feelings that come with those thoughts long enough to realize that he’s still ok.

      In obsessive compulsive disorder, there is a psychotherapy treatment called “exposure and response prevention.”  In this treatment, the person with the ego-dystonic fear exposes themselves to their fear for a progressive amount of time.  They realize that after going where the fear is over and over and materially seeing that nothing bad happens, the fear looses more and more control over them.

      This is effective in any anxiety condition, including shame.

      Self-Care Tip #83 – Get gangster on your shame.  Be a friend to yourself.

      Question:  Has shame bullied you?  Please tell me your story.

      by

      Your Heroic Self – Waiting For Normal

      Self-Care Tip #82 – Have courage to go for what is lovely to you in life.  Be a friend to yourself.

      Pretty, blond, about 5’6″, slender, in her 30’s, mother and wife, no funny shapes or movements but Britt still asked me, “Am I normal?”  It takes guts to ask someone that.

      I just finished this heart-squeezing book, “Waiting For Normal,” by Leslie Connor.  (Yes!  I finally read a book!  It took me 5 times as long but it was no less pleasurable.)  Connor tells us about pre-teen Addie who grew up on the waves of her bipolar mom’s chaos, salvaging bits of wreckage along the way to survive.  Addie is the life-preserver her mom uses for life.  Addie’s own buoy through it all is her hope of one day finding normalcy.  She uses all her smarts to avoid the thrust her mom’s messes force on her.  It requires her full attention.  Addie must have looked pressed for something because her Mom finally asked her

      What’s so special?  What are you chasing after?!

      Addie was fisting optimism when she answered

      I’m not chasing after anything.  I’m waiting.  Waiting for normal.

      Later Addie explains to her mom

      Normal is when you know what’s gonna happen next.  Not exactly what because probably nobody gets that.  But normal is being able to count on certain things.  Good things.  And it’s having everyone together – just because they belong that way.

      My son used to have shaggy hair with curls that flew at the world around him.  He came home the other day and told me he wanted it short.  I finally figured out that because none of the other boys in his class had longer hair, neither should he.  He showed me pictures of what his hair should look like.  The whole process was too cute.

      We are all looking for normal.

      Putting aside defining normal, for now I am content to just contemplate the largeness of the effort to find it.  The journey, the process, the coming into such a thing reveals the beauty in one’s character and essence.  It is that, rather than the “hair-cut” that makes me say, “Wow!”

      When Britt, my patient, strove towards her health and normalcy, her intent in context was lovely.  She seemed to me, in those moments we shared together, as one of the great heroes of our day.  A woman of courage.

      Self-Care Tip #82 – Have courage to go for what is lovely to you in life and appreciate the beauty in your heroic self.  Be a friend to yourself.

      Question:  Have you struggled with the question, “Am I normal?”  Please tell me your story.

      by

      Connect With Others to Get Friendly With Yourself

      Self-Care Tip #81 – Connect with others.  Be a friend to yourself.

      So you have bought into the famous, “You are not alone” stock.  After 2 months on psychotropics (medications for emotional illness,) you finally have an interest in people.  You are at least a little motivated and less afraid of things that move.  You don’t feel like you are the reason for original sin and more often than not, you think happiness might be more than what shopping can offer.  What is this strange and unfamiliar sensation?  And what to do with it?

      It is time to connect.  Many of us get to the point where we no longer want to hide, we don’t hate ourselves, and we don’t hate others.  We get to the place of showing our under-belly just a little to the big wide world and are shocked that the only thing we feel is the wind as everyone is rushing by!  Just when we start wanting what we spent so much time hiding from, we seem to have forgotten how to connect with others.

      It is no secret.  America is culturally impoverished.  We have little of cobblestone streets to meander down, dressed in clean clothes after a days work, checking up on neighbors and gossip.  We have few degrees of activity between full throttle and dead/no heart beat.   Come now!  How to connect in a world where our parents expected us to pay rent when we turned 18years old?

      If you find yourself in something of this situation try on one of these basic tools and see what fits.  You can’t expect them all to.  So if you strike out a few times, keep on!

      1.  Volunteer – for example, and in no particular order…

      2.  Meetup.com – an awesome site to find people interested in what you are interested in.  e.g. book clubs, skiing, small business, Italian

      3.  Support groups

      4.  Write!  Although this at first thought may appear isolating, it is not necessarily.

      • Blog!  🙂
      • Journal

      5.  Toastmasters

      There is so much more.  Please let me know your thoughts and I’ll keep adding to this list!

      Self-Care Tip #81 – Connect with others.  Be a friend to yourself.

      by

      Intent and Context Matter

       

      A Beautiful Mind by Sylvia Nasar

      Image via Wikipedia

       

      Self-care is selfless, but doing things for yourself is not always self-care.

      A reader commented, “I believe that if I’m NOT taking care of myself and feeling joy, then that IS self-centered….”  Too eloquent.  Love it.

      Some of our confusion comes from the changing scenarios of self care.  The intent sometimes gets blurry.  The intent is hard to tease apart.  Sometimes what feels like taking care of ourselves is in fact, selfish.  For example, let’s say “hypothetically,” my husband, who is a palliative care specialist, chooses to work on twitter #hpm, play chess, or play guitar.  This is potentially positive and friendly to the self.  However, it depends on intent.  Sometimes we don’t know our own intent though.

      There is also the context of what is happening.  Let’s say we were all fighting, and then my husband goes off to read Oscar Wilde.   Is this self-care or a way of abandoning and taking himself out of the present?  Self-care puts us into the present.  Whereas selfishness takes us out.

      In another context, taking yourself out of the present is necessary to ultimately put yourself back in.  Doing this requires thought processes that can abstract and empathize (connect emotional content).

      I rely a lot on intent! (Ahem!)

      There is a mind disease called schizophrenia.  This disease is famous for hallucinations, hearing voices that other people don’t hear, seeing things that other people don’t see.  However the core symptom of schizophrenia is less famous.  It is the thought form, concrete and disconnected.

      Concrete thinking is named well, unlike many other medical conditions.  (Think diabetes!  Who would know what that has anything to do with!?)  But concrete thinking is plain, hard, and flat like my sidewalk.  For example, if I asked what does the parable mean, “A bird in the hand is worth more than two in the bush?”

      1. Concrete thinkers might say, “Birds make a mess so we don’t want a lot of them.”
      2. Further, if their thoughts are also not connected, they might say, “Birds migrate in the winter and the bush is wet.”
      3. Contrast this to connected thought that abstracts, being able to answer, “If I have an opportunity to take something good, it’s better to take it than gamble for what I might not be able to keep in the end.”

      Different emotional illnesses have trouble abstracting, but fewer have disconnected thoughts like schizophrenia.

      If you are in a relationship with someone who has trouble abstracting (traumatic brain injury) and/or connecting emotional content (ADHD for example,) you might misinterpret his or her behaviors as selfish.  Being able to empathize after all is part of most Disney fairy-tail romances.  What more do any of us want?  Right?

      Wrong.  The capacity to empathize doesn’t matter much if the intent is missing.

      Wrong.  The ability to abstract doesn’t connect if the intent to connect us is not there.  The knowledge does not matter.  It is the context.

      In the film, A Beautiful Mind, Russel Crowe plays a character that suffers from schizophrenia.  The woman who loves him, struggles to understand the way he loves her back.  His disease steals his attention.  His disease takes his time.  He seems selfish.  Their love survives when she discovers his intent in context.  He stays present in the relationship, despite all his limited capacity to relate.  Further, agreeing to the treatments of his generation, limited that they are, he is doing selfless self-care.

      At the end of the day, I’m a grateful piece of dirt who means well.  Saying that up front immediately lets you get very familiar with me.  (I could have said “grateful piece of sh–,” but that would have been selfish.  The s-bomb is just playing with the word to have fun!)  Part of why I believe in God is because I know He goes for the losers.  He goes for the piece of craps out there.  That’s what the beatitudes are about.  He pours it on. (Intent and context, baby!)  At the end of the day, we are neither angel nor beast.  We are just human to Him.

      Self-Care Tip #78 – Keep self-care selfless.  Be a friend to yourself. 😉

      Question:  What do you think?  Please tell me your thoughts.  Please tell me your story.

      by

      Taking Care of Yourself Is Not Selfish

      The line between self-care and self-centeredness is a thin line.  We are part of the narrative.  We are not the narrative.

      I’ve got some heat lately folks for talking about “Me” in a way that excludes the import of “You.”  How does anyone talk about the importance of the self without sounding seriously arrogant, disinterested in others, egocentric, ungrateful and rude?  Clearly it’s a learning process.  That’s something of what I’m hoping will evolve this year as we journey together.  Please let me know what you think on this subject.

      I was very excited about having a morning to myself today and had built up a storybook page turning space of time for me.  However my night went bad, and like opening the oven door too soon with the bread still rising, I just didn’t get up well.  Partly in denial that the day was already slipping away, I kept going towards my hopes.  The clock sped up and I finally got out the door with the kids buckled to where they needed to go.  And then I realized I forgot my computer and phone.  Not so easy to work without those.

      I live in the hills and although I’m not far from street lights and normal trafficked buildings, getting between me and them takes me through many blind 25 mph corners, steep hills over narrow roads.  Today I felt like I got caught in those hills.  My mom-van felt off-balance and the tight corners treated my tires cruelly.  I went back home to get my computer and back down to town finally.

      I had great intentions for today.  However, I got stuck and stuck again.  That is what it can be like when we try to treat ourselves well.  It can feel like the roads swallow us up and we just can’t get there.

      As my husband says, “That’s how it rolls!”

      Question:  How do you see self-care differently from self-centeredness?  Please tell me your story of friendship.

      Self-Care Tip #77 – Don’t get confused.  Taking care of yourself is not selfish.  Be a friend to yourself.

      by

      Choose, Gladly, Using Resources

      Being a friend to yourself includes choosing, being glad that you can, and using resources to make your choice a good one.

      Mrs. Smith told me with a barely noticeable arch in her back that she was still planning on God healing her daughter.  I don’t know if Mrs. Smith thought about how her daughter felt about that.  Was Kristy personalizing her illness?  Did she think God rejected her?  The problem of her continued illness must show something more than a physical flaw in her perhaps.

      Will we know it when we are healed?  Until then, what to do?

      Years ago, I met Fran.  She was pulling her hair out.  Her annoyed husband disrespected her for it.  Fran kept willing herself to stop.  She said,

      I’m doing it less now I think.

      The good news for Fran is that she responded well to fluoxetine.  Her anxiety decreased and she almost stopped pulling out her hair.  She’d wear her growing bristles pressed down with bobby-pins and hide it with her long hair.  As her hair grew longer, she had fewer bobby-pins and I knew she was taking her medication.  There were other problems between Fran and her medications.  Taking medication shamed her.  And, she blamed her fluoxetine for her weight gain and rash on her face.  She felt uglier than ever in her husband’s eyes.

      I don’t pull hair any more.

      Fran stopped her fluoxetine and half her head went bald.  She did not lose weight and she still had a rash on her face.  Fran went back on her fluoxetine and she has cycled on and off of it this way over the years we’ve worked together.  Somehow despite all our time together, Fran does not believe me when I tell her that when she is better symptomatically, she is not healed.  Fran does not grasp that her behaviors come from something at a genetic level.  We can treat her, influencing the way her genes express themselves, but in her case, not cure her.

      We are a team.  She and I, and sometimes her husband, and sometimes her sister.  I give her medications when she thinks she needs it.  I don’t leave her when she doesn’t.  Either way, we keep trying.  It is very hard for Fran to know that she has not been healed.

      I don’t have many clear examples of treatment-to-cure in psychiatry.  The statistics vary between diseases as to their rates of recurrence.  The brain being human, we can yell at the serpent for our insanity.  However, in the end, here we are.  As Billy Joel says in his great ’70’s hit song “My Life”

      Either way it’s okay to wake up with yourself.

      The opportunity to choose our own answers, to decide what to do about it, and believing if we are sick or not sick  – is all our own.  These can be hard decisions but until we lose capacity to choose, we own them.  Decision making capacity of course is a medical decision.  But competency is a legal decision made in a court of law.  Having the right to choose is a beautiful privilege.  This does not mean to ignore counsel, evidence, data.  On the contrary.  That would not be a friendly thing to do to yourself.

      Self Care Tip # 75 – Choose well and be glad you can.  Be a friend to yourself.

      Question:  What do you think?  Agree or disagree.